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Health care reform bill seen as a good first step

This was a session that started out with a pledge to achieve nearly universal health insurance coverage in Minnesota within the next five years. By that measure the state has a long way to go. In the end about 12,000 of the state's more than 400,000 uninsured people will get the chance to sign up for health coverage.

Lawmakers had also hoped to reign in health care cost increases by 20% over the next few years. But the bill they passed probably won't cut costs by much more than half of that.

A chief author of the reform bill, Sen. Linda Berglin, DFL-Minneapolis, says she is disappointed with a few aspects of the final legislation. But she's glad lawmakers at least passed some of the reform measures.

"I had hoped that we would go a little farther, but I believe after we get started and providers and consumers see how this is working, I believe then we will finish what we started."

As part of the legislation doctors will receive extra payments for properly managing a patient's chronic health condition. There's also money available to communities to implement ideas for reducing obesity and tobacco use rates.

DFLers did relent somewhat on a pledge not to use surplus money from the Health Care Access Fund to pay for anything other than health care. The final legislation borrows $50 million from the fund to help plug the state project $935 million dollar budget deficit.

Rep. Paul Thissen, DFL-Minneapolis, says it was a necessary compromise that doesn't risk a lot in the end.

"The important thing for us is that there's a mechanism in the legislation that will require that money to be paid back and that's tied to seeing savings coming off of our health care reform," he says. "So I think it puts an incentive on all of us to make sure that those savings do result from the work that we did this year and we expect that they will and we expect that money ultimately in relatively short order will be repaid into the Health Care Access Fund."

Outside of the Capitol, reaction to the health reform bill is mixed.

The session didn't live up to its dramatic reform promise, according to Dan McGrath, executive director of the grassroots consumer group TakeAction Minnesota.

"We expected to get a lot more done than what has been achieved in this session."

While it's good that 12,000 more Minnesotans will get health coverage, it hardly makes a dent in what is a growing and urgent health care access problem, says McGrath. He predicts voters won't be impressed with lawmakers' reforms.

"It'll be important to hear what Minnesotans say during this election season. Voters have been consistently saying that health care is one of their top priority issues. So I don't think that legislators or the governor can afford not to take bolder action given what public sentiment has been saying."

Hospitals are another group that is smarting from the last-minute budget compromises. In a separate Health and Human Services budget bill, Medicaid payments to hospitals were slashed more than 3-percent next year, with additional cuts in subsequent years.

Lawmakers may have had a goal of saving money on health care, but their actions will likely raise the costs of care at hospitals, says Bruce Rueben, president of the Minnesota Hospital Association.

"So that means there's unmet costs which have to be met. And that means those costs will have to be born by those who can pay for health care services."

In other words, people with insurance will likely see their health premiums rise, which he says is exactly the opposite of what lawmakers were hoping to achieve this session with their reform initiatives. Budget cuts aside, Rueben says, his organization is supportive of lawmakers health care reform efforts.

Others are more effusive in their praise. Even though the legislation has been described as just a first step toward reforming the health care system, it's a critical first step, says Frank Cerra, senior vice president for Health Sciences at the University of Minnesota.

"The methods of reforming and reorganizing the health care system are something that has to develop over a series of years and continuous reforms. I don't think it can be implemented in one fell swoop. And I think what they've done is set us on that pathway and I commend that."

Lawmakers say they hope to build on their reforms next year. But with another looming budget deficit on the horizon, it's likely that the reform process won't get any easier.